Director Pharmacy (Job Number:11601)
Description
Summary:
This position is accountable for the overall operating results of the pharmacy program. Specific responsibilities include, but are not limited to: establishing and achieving strategies, plans, and objectives for the pharmacy program; developing and maintaining pharmacy formularies; developing and implementing new products; developing local and national pharmacy provider networks; negotiating contracts and managing relationships with pharmacy providers and suppliers; and assuring the effectiveness and quality of the pharmacy business unit’s operations whether through a vendor relationship with an outside third party or through in-house capabilities. The position establishes and refines benchmarks in order to evaluate pharmacy performance in cost, quality, access and satisfaction.
Accountabilities:
1. Analyze pharmacy benefits policy and practice to ensure proper position of pharmacy benefits in the market.
2. Evaluate current pharmacy programs, assist in the development of implementation of new programs to ensure comprehensive pharmacy programs for members.
3. Ensure coordination between BCBSM and its PBM in relation to strategic and tactical business needs, service issues, technology recommendations and operational issues.
4. Coordinate research and analysis on competitive, environmental, financial, industry, regulatory, consumer and demographic factors, critical success factors and contingency plans. Extract and convey key trends, challenges, and opportunities facing the industry.
5. Monitor and take appropriate actions on contractual pharmacy programs to ensure costs and quality are managed through competent formulary maintenance, accurate claims processing, and optimal pharmacy contracting.
6. Develop and maintain drug utilization review programs to ensure costs and quality are managed through effective patient monitoring of drug therapy protocols to reduce variations, effect drug use evaluation, and efficient accumulating, analyzing and utilization of data.
7. Serve as liaison with any third-party Pharmacy Benefit Management company and the pharmacy community to ensure effective communication between purchasers and providers of pharmacy benefits.
8. Manage and coordinate assigned projects. Establish goals and success measures, keep projects on track, resolve issues, ensure that all viewpoints are heard, develop consensus, provide final documentation for all critical issues and disseminate appropriate information.
9. Develop and negotiate service/quality benchmarks based on business needs.
10. Facilitate ongoing dialogue (both formally and informally) with senior management. Develop various presentations and documents for CEOs, VPs and Boards of Directors.
Qualifications
Required Qualifications:
- Accepting this director level position at BCBSMN requires signing an Agreement Regarding Non-Disclosure of Confidential Information and Non-Competition as a condition of employment.
- Bachelors degree in pharmacy required and 7 years of health plan or PBM experience.
- 5 years of staff management experience
- Thorough understanding of healthcare industry fundamentals and terminology or thorough knowledge of pharmaceutical industry, pharmacy as a benefit and clinical familiarity depending on background
- Ability to work with a high degree of independence and manage multiple priorities.
- Ability to analyze, interpret, and apply findings from research regarding business and industry issues.
- Strong relationship-building skills. Ability to work effectively in a matrix organization and give appropriate consideration to conflicting perspectives and values. Ability to gain influence, credibility and respect. Ability to lead multidisciplinary teams.
- Demonstrated effective written, oral and presentation and communication skills.
Preferred Qualifications:
- PharmD degree preferred.
Blue Cross and Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action Employer, M/F/D/V. Blue Cross and Blue Shield of Minnesota is a drug free workplace. Candidates are required to pass a background check and drug test before beginning employment.
Primary Location: United States-Minnesota-Eagan
Shift: Day Job
Description
Summary:
This position is accountable for the overall operating results of the pharmacy program. Specific responsibilities include, but are not limited to: establishing and achieving strategies, plans, and objectives for the pharmacy program; developing and maintaining pharmacy formularies; developing and implementing new products; developing local and national pharmacy provider networks; negotiating contracts and managing relationships with pharmacy providers and suppliers; and assuring the effectiveness and quality of the pharmacy business unit’s operations whether through a vendor relationship with an outside third party or through in-house capabilities. The position establishes and refines benchmarks in order to evaluate pharmacy performance in cost, quality, access and satisfaction.
Accountabilities:
1. Analyze pharmacy benefits policy and practice to ensure proper position of pharmacy benefits in the market.
2. Evaluate current pharmacy programs, assist in the development of implementation of new programs to ensure comprehensive pharmacy programs for members.
3. Ensure coordination between BCBSM and its PBM in relation to strategic and tactical business needs, service issues, technology recommendations and operational issues.
4. Coordinate research and analysis on competitive, environmental, financial, industry, regulatory, consumer and demographic factors, critical success factors and contingency plans. Extract and convey key trends, challenges, and opportunities facing the industry.
5. Monitor and take appropriate actions on contractual pharmacy programs to ensure costs and quality are managed through competent formulary maintenance, accurate claims processing, and optimal pharmacy contracting.
6. Develop and maintain drug utilization review programs to ensure costs and quality are managed through effective patient monitoring of drug therapy protocols to reduce variations, effect drug use evaluation, and efficient accumulating, analyzing and utilization of data.
7. Serve as liaison with any third-party Pharmacy Benefit Management company and the pharmacy community to ensure effective communication between purchasers and providers of pharmacy benefits.
8. Manage and coordinate assigned projects. Establish goals and success measures, keep projects on track, resolve issues, ensure that all viewpoints are heard, develop consensus, provide final documentation for all critical issues and disseminate appropriate information.
9. Develop and negotiate service/quality benchmarks based on business needs.
10. Facilitate ongoing dialogue (both formally and informally) with senior management. Develop various presentations and documents for CEOs, VPs and Boards of Directors.
Qualifications
Required Qualifications:
- Accepting this director level position at BCBSMN requires signing an Agreement Regarding Non-Disclosure of Confidential Information and Non-Competition as a condition of employment.
- Bachelors degree in pharmacy required and 7 years of health plan or PBM experience.
- 5 years of staff management experience
- Thorough understanding of healthcare industry fundamentals and terminology or thorough knowledge of pharmaceutical industry, pharmacy as a benefit and clinical familiarity depending on background
- Ability to work with a high degree of independence and manage multiple priorities.
- Ability to analyze, interpret, and apply findings from research regarding business and industry issues.
- Strong relationship-building skills. Ability to work effectively in a matrix organization and give appropriate consideration to conflicting perspectives and values. Ability to gain influence, credibility and respect. Ability to lead multidisciplinary teams.
- Demonstrated effective written, oral and presentation and communication skills.
Preferred Qualifications:
- PharmD degree preferred.
Blue Cross and Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action Employer, M/F/D/V. Blue Cross and Blue Shield of Minnesota is a drug free workplace. Candidates are required to pass a background check and drug test before beginning employment.
Primary Location: United States-Minnesota-Eagan
Shift: Day Job